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https://www.readbyqxmd.com/read/29664888/development-and-validation-of-a-deep-neural-network-model-for-prediction-of-postoperative-in-hospital-mortality
#1
Christine K Lee, Ira Hofer, Eilon Gabel, Pierre Baldi, Maxime Cannesson
BACKGROUND: The authors tested the hypothesis that deep neural networks trained on intraoperative features can predict postoperative in-hospital mortality. METHODS: The data used to train and validate the algorithm consists of 59,985 patients with 87 features extracted at the end of surgery. Feed-forward networks with a logistic output were trained using stochastic gradient descent with momentum. The deep neural networks were trained on 80% of the data, with 20% reserved for testing...
April 17, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29615276/-cr-possum-and-surgical-apgar-score-as-predictive-factors-for-patients-allocation-after-colorectal-surgery
#2
Sílvia Pinho, Filipa Lagarto, Blandina Gomes, Liliana Costa, Catarina S Nunes, Carla Oliveira
BACKGROUND AND OBJECTIVES: Surgical patients frequently require admission in high-dependency units or intensive care units. Resources are scarce and there are no universally accepted admission criteria, so patients' allocation must be optimized. The purpose of this study was to investigate the relationship between postoperative destination of patients submitted to colorectal surgery and the scores ColoRectal Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) and Surgical Apgar Score (SAS) and, secondarily find cut-offs to aid this allocation...
March 31, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29570035/predictors-of-mortality-in-children-with-myelomeningocele-and-symptomatic-chiari-type-ii-malformation
#3
Michael M McDowell, Jason E Blatt, Christopher P Deibert, Nathan T Zwagerman, Zachary J Tempel, Stephanie Greene
OBJECTIVE Chiari malformation type II (CM-II) in myelomeningocele is associated with a significant rate of mortality and poor outcome. Death is frequently heralded by the onset or progression of neurological symptoms. The authors sought to identify predictors of poor outcome and mortality within the myelomeningocele population at Children's Hospital of Pittsburgh. METHODS A retrospective chart and radiology review was performed on all infants who underwent primary closure of a myelomeningocele defect at Children's Hospital of Pittsburgh between the years of 1995 and 2015...
March 23, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29556880/critical-care-management-of-peritonitis-in-a-low-resource-setting
#4
Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29466901/modified-isth-pregnancy-specific-dic-score-in-parturients-with-liver-rupture-population-based-case-series
#5
Ranit Hizkiyahu, Anat Rabinovich, Jecko Thachil, Eyal Sheiner, Gad Shaked, Gilbert Sebbag, Eli Maymon, Offer Erez
OBJECTIVES: Liver rupture and hematoma are rare life-threatening complications of pregnancy. The aims of the current study are to: (1) characterize in a population-based study all cases of liver hematoma and/or rupture; and (2) validate the utility of the International Society on Thrombosis and Haemostasis (ISTH) modified pregnancy specific disseminated intravascular coagulation (DIC) score in those cases. STUDY DESIGN: A retrospective cohort study including all patients with liver subcapsular hematoma or rupture between the years 1996 and 2012 was conducted...
February 21, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29459245/the-surgical-apgar-score-predicts-outcomes-of-emergency-abdominal-surgeries-both-in-fit-and-frail-older-patients
#6
Jakub Kenig, Kinga Mastalerz, Katarzyna Lukasiewicz, Maria Mitus-Kenig, Urszula Skorus
The Surgical Apgar Score (SAS) is a simple and rapid scoring system predicting postoperative mortality and morbidity. However, it remains unknown whether it might be useful in fit and frail older patients undergoing abdominal emergency surgery. METHODS: Consecutive patients ≥65 years, needing emergency abdominal surgery were enrolled in this prospective study. Additionally to the SAS, the G8 screening score was used to determine the frailty status. The logistic regression analysis was conducted investigating the association between the scores and 30-day postoperative outcomes...
February 10, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29436276/utility-of-the-modified-surgical-apgar-score-in-a-head-and-neck-cancer-population
#7
Kristine E Day, Andrew C Prince, Chee Paul Lin, Benjamin J Greene, William R Carroll
Objective The Surgical Apgar Score (SAS) is a validated postoperative complication prediction model. The purpose of this study was to investigate the utility of the SAS in a diverse head and neck cancer population and to compare it with a recently developed modified SAS (mSAS) that accounts for intraoperative transfusion. Study Design Case series with chart review. Setting Academic tertiary care medical center. Subjects and Methods This study comprised 713 patients undergoing surgery for head and neck cancer from April 2012 to March 2015...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29428034/impact-of-trauma-certified-registered-nurse-anesthetists-team-on-intra-operative-resuscitation-and-postoperative-outcomes-of-trauma-patients
#8
Juan Duchesne, Chad Majoue, Marquinn Duke, Rosemarie Robledo, Chad Achord, Leslie McHale, Brandy Davis, Lusine Nahapetyan
A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS)...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29416485/surgical-apgar-score-for-predicting-patient-outcome-after-hepatopancreaticobiliary-surgeries
#9
Abhijit S Nair
No abstract text is available yet for this article.
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29406172/the-impact-of-neuraxial-clonidine-on-postoperative-analgesia-and-perioperative-adverse-effects-in-women-having-elective-caesarean-section-a-systematic-review-and-meta-analysis
#10
REVIEW
T K Allen, B M Mishriky, R Y Klinger, A S Habib
Neuraxial clonidine improves postoperative analgesia in the general surgical population. The efficacy and safety of neuraxial clonidine as a postoperative analgesic adjunct in the Caesarean section population still remains unclear. This systematic review and meta-analysis aims to evaluate the effect of perioperative neuraxial clonidine on postoperative analgesia in women having Caesarean section under neuraxial anaesthesia. We included randomized controlled trials comparing the analgesic efficacy of the perioperative administration of neuraxial clonidine alone or in combination with a local anaesthetic and/or opioids in women having elective Caesarean section under neuraxial anaesthesia when compared with placebo...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29327897/peripheral-arterial-occlusive-disease-and-perioperative-risk
#11
Peter Poredos, Pavel Poredos
Surgical procedures represent a risk for different complications which may appear during the perioperative period. Cardiac ischemic events and vascular complications are the most important causes of increased morbidity and mortality and they are much more frequent in patients with manifest cardiovascular disease. This is particularly seen in patients with peripheral arterial occlusive disease (PAD), which represents advanced atherosclerosis frequently accompanied by the presence of coronary artery disease. Therefore, patients with PAD need careful preoperative examination, including estimation of functional capacity and the presence of other co-existing atherosclerotic diseases...
April 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29273361/surgical-apgar-score-for-predicting-complications-after-hepatectomy-for-hepatocellular-carcinoma
#12
Yoshito Tomimaru, Koji Takada, Toru Shirakawa, Kozo Noguchi, Shunji Morita, Hiroshi Imamura, Takashi Iwazawa, Keizo Dono
BACKGROUND: Surgical Apgar score (SAS) was recently proposed as a simple predictor of postoperative complications. A few studies have shown the utility of the SAS in some kinds of surgeries, but it has not been investigated in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). METHODS: This study included 158 patients undergoing hepatectomy for HCC. The association between SAS and postoperative complications was examined. The patients had postoperative morbidities classified as Clavien-Dindo grade II or higher...
February 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29184910/adapting-the-surgical-apgar-score-for-perioperative-outcome-prediction-in-liver-transplantation-a-retrospective-study
#13
Amy C S Pearson, Arun Subramanian, Darrell R Schroeder, James Y Findlay
Background: The surgical Apgar score (SAS) is a 10-point scale using the lowest heart rate, lowest mean arterial pressure, and estimated blood loss (EBL) during surgery to predict postoperative outcomes. The SAS has not yet been validated in liver transplantation patients, because typical blood loss usually exceeds the highest EBL category. Our primary aim was to develop a modified SAS for liver transplant (SAS-LT) by replacing the EBL parameter with volume of red cells transfused. We hypothesized that the SAS-LT would predict death or severe complication within 30 days of transplant with similar accuracy to current scoring systems...
November 2017: Transplantation Direct
https://www.readbyqxmd.com/read/29173311/predicting-mortality-or-intestinal-failure-in-infants-with-surgical-necrotizing-enterocolitis
#14
COMPARATIVE STUDY
Darshna Bhatt, Curtis Travers, Ravi M Patel, Julia Shinnick, Kelly Arps, Sarah Keene, Mehul V Raval
OBJECTIVE: To compare existing outcome prediction models and create a novel model to predict death or intestinal failure (IF) in infants with surgical necrotizing enterocolitis (NEC). STUDY DESIGN: A retrospective, observational cohort study conducted in a 2-campus health system in Atlanta, Georgia, from September 2009 to May 2015. Participants included all infants ≤37 weeks of gestation with surgical NEC. Logistic regression was used to model the probability of death or IF, as a composite outcome, using preoperative variables defined by specifications from 3 existing prediction models: American College of Surgeons National Surgical Quality Improvement Program Pediatric, Score for Neonatal Acute Physiology Perinatal Extension, and Vermont Oxford Risk Adjustment Tool...
December 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29146268/surgical-apgar-score-predicts-30-day-morbidity-in-elderly-patients-who-undergo-non-laparoscopic-gynecologic-surgery-a-retrospective-analysis
#15
Kazumi Kurata, Yoko Chino, Akiko Shinagawa, Tetsuji Kurokawa, Yoshio Yoshida
INTRODUCTION: The aim of this study was to determine whether a preoperative health status index and intraoperative data could predict perioperative morbidity and mortality in women over the age of 65 years undergoing surgery for gynecologic disorders. METHODS: The medical records of 68 female patients who were ≥65 years of age and who underwent surgery under general anesthesia in our institute from January 2014 to December 2015 were retrospectively reviewed. Preoperative data were extracted from a database and included comorbidities, American Society of Anesthesiologists physiological status classification, the Charlson Comorbidity Index, the Subjective Global Assessment 2011 revision, the subjects' risk of falling, body mass index, and age...
December 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29035696/the-reliability-of-surgical-apgar-score-in-predicting-immediate-and-late-postoperative-morbidity-and-mortality-a-narrative-review
#16
Abhijit Nair, Aanchal Bharuka, Basanth Kumar Rayani
Surgical Apgar Score is a simple, 10-point scoring system in which a low score reliably identifies those patients at risk for adverse perioperative outcomes. Surgical techniques and anesthesia management should be directed in such a way that the Surgical Apgar Score remains higher to avoid postoperative morbidity and mortality.
October 13, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/29033722/effect-of-intravenous-phenylephrine-infusion-on-dose-requirement-of-intrathecal-plain-levobupivacaine-for-cesarean-section-a-placebo-controlled-preliminary-study
#17
Asha Tyagi, Aanchal Kakkar, Namrata Niwal, Medha Mohta, Ashok Kumar Sethi
BACKGROUND: Phenylephrine infusion has been shown to decrease rostral spread of plain and hyperbaric local anesthetic (LA) when compared to ephedrine infusion. However, it does not result in higher dose requirement of hyperbaric LA for cesarean section. There is no trial evaluating the effect of phenylephrine infusion on ED50 of a plain intrathecal LA. METHODS: Pregnant patients with term uncomplicated singleton pregnancy undergoing elective cesarean section were given combined spinal-epidural anesthesia...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033614/fusion-of-lower-limbs-with-severe-urogenital-malformation-in-a-newborn-a-rare-congenital-clinical-syndrome-case-report
#18
Fatemah Al Hadhoud, Abeer H Kamal, Abdulmohsen Al Anjari, Michael Fe Diejomaoh
BACKGROUND: Fused lower limbs combined with severe urogenital malformation, also known as sirenomelia, is a rare congenital clinical syndrome. The etiology is unknown, and the outcome for the affected fetus is rather uncertain. CASE REPORT: Mrs RB, a Kuwaiti woman primigravida, married to a non-consanguineous husband, had uneventful antenatal care in a private health service, until she was admitted to the Maternity Hospital, Kuwait, at 31 weeks of gestation with a 3-hour history of ruptured membranes...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/28986819/the-surgical-apgar-score-predicts-not-only-short-term-complications-but-also-long-term-prognosis-after-esophagectomy
#19
Akio Nakagawa, Tetsu Nakamura, Taro Oshikiri, Hiroshi Hasegawa, Masashi Yamamoto, Shingo Kanaji, Yoshiko Matsuda, Kimihiro Yamashita, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
BACKGROUND: The surgical Apgar score (SAS) quantifies three intraoperative factors and predicts postoperative complications, but few reports describe its usefulness in esophagectomy, and no studies to date show its correlation with long-term prognosis after esophagectomy. METHODS: This study investigated 400 cases in which esophagectomy was performed on esophageal malignant tumors at the authors' hospital from January 2007 to January 2017. In this study, SAS was defined as the sum of the scores of three parameters, namely, estimated blood loss, lowest mean arterial pressure, and lowest heart rate, with values extracted from medical records...
December 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28937460/utility-of-the-surgical-apgar-score-for-patients-who-undergo-surgery-for-spinal-metastasis
#20
Darryl Lau, Timothy J Yee, Frank La Marca, Rakesh Patel, Paul Park
STUDY DESIGN: Retrospective review of patients who underwent surgery for spinal metastasis between 2005 and 2011. OBJECTIVE: To assess the utility of the surgical Apgar score (SAS) in patients who underwent surgery for spinal metastasis. SUMMARY OF BACKGROUND DATA: Surgery for spinal metastasis can be associated with relatively high morbidity and mortality. Consequently, identifying patients at risk for major postoperative complications is important...
October 2017: Clinical Spine Surgery
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